Although now entering its fourth decade, in recent years Care and Repair Edinburgh (C&RE) has been undergoing a transformation that has seen a very deliberate effort to rise to the challenges set by the speedy social and demographic changes under way across Scotland.
The budget settlement for local authorities will require a mixture of efficiencies and cuts. The government has also set aside an additional £250 million for integration of health and social care in a bid to build the capacity of community-based services – the SNP’s key health reform in the current parliament.
This is in part a recognition that arguably the greatest challenge that currently faces public services are the pressures related to caring for an ageing population at a time when the demands on the evolving system of health and social care are becoming increasingly difficult to meet.
The digital realm offers benefits and opportunities, but there is also a risk of community alienation as people interact in new ways that can, for some elderly people especially, feel excluding. In years gone by we would have shopped, worshipped, travelled and socialised locally. Nowadays, how many of us know more than our immediate neighbours?
The question is, how can we use the resources available to make sure that communities that are changing beyond recognition do so in ways that recognise the needs of the older people and the vulnerable and cater to them both meaningfully and sustainably?
In truth there’s no simple answer; it’s about how communities pull and work together and leverage the resources they have in new ways that work best for them.
2012’s Christie Commission on the future of public services was right to suggest that there is a need to prioritise expenditure on public services which prevent negative outcomes arising. That is why C&RE has set about developing new service models that dovetail with the priorities of public service providers in the capital, aligning to the emerging health and social care integration landscape. A key aim is to ensure that vulnerable people receive support that helps to prevent admission and readmission to hospital.
C&RE’s ongoing success lies in the strength of its partnerships. Having worked closely with the City of Edinburgh Council since 1985 we are keen to do more to work with the public sector to develop and implement innovative, cost effective services that help older and disabled people to live independently in their own homes. To that end, we are in the process of implementing a new “Discharge Support Service” to support NHS Lothian and the city council.
The intervention is timely. The most recent ISD Scotland figures suggest that in September 2015 there were 48,091 days spent in hospital associated with delays in discharge. Nationally, 70 per cent of these bed days are occupied by patients aged 75 and over.
There’s a growing appreciation that practical support of the sort provided by third-sector bodies is vital to ensuring that older members of our communities don’t have to rely on more expensive public services. Yet there is far more that can be done to ensure they become more “mainstream” across Scotland.
C&RE aims to develop and extend its services to help public authorities match key priorities like delivering effective services designed with and for people and communities and maximising scarce resources by utilising all available from the public, private and third sectors, individuals, groups and communities.
There is further capacity in our communities to help those who can’t help themselves and we remain aware that while we have to be ambitious in creating programmes that support public services, it is often our volunteers who act as the glue that holds neighbourhoods together; their willingness to exchange some friendly words over a cup of tea makes the lives of vulnerable people better.
• Tim Dew is chairman, Care and Repair Edinburgh